초록

17년 전에 관상동맥 우회술을 시술 받은 63세 환자가 인공 심박동기 삽입 후 발생한 국소 감염으로 입원하였다. 피부 절개 후 심박동기를 견인하여 제거하려 하였으나 와이어가 뽑히지 않았고, 와이어는 절단하여 체내에 남겨둔 채로 치료를 종료하였다. 그러나 반복적으로 국소 감염이 재발하였고, 이에 우측 개흉술로 접근하여 인공 심폐 순환 후, 순환 정지 하에 우심방을 열고 와이어를 제거하였다.

Abstract

A 63-year-old man who had a permanent pacemaker placed 17 years ago presented to us with local inflammatory signs on his chest. The skin was opened to remove the permanent pacemaker. However, the pacing wire was not easily removed. So, the permanent pacemaker was removed from the chest with leaving the remnant wire inside. However, the local infection recurred because of the remnant wire. Right thoracotomy was performed and cardiopulmonary bypass was started. After total circulatory arrest, the right atrium was opened and the wire was completely removed.

주제어

#심박동기   #감염   #개심술  

저자의 다른 논문

참고문헌 (6)

1. del Rio A, Anguera I, Miro JM, et al. Surgical treatment of pacemaker and defibrillator lead endocarditis. Chest 2003; 124:1451-9 
2. Cho EH, Choi PJ, Ham SY, Sung SC, Woo JS. Removal of infected transvenous pacemaker electrode −2 cases-. Korean J Thorac Cardiovasc Surg 1995;28:404-8 
3. Park CH, Woo JS, Cho KH. Subpectoral relocation method for treating the exposed well functioning cardiac pacemaker (report of one case). Korean J Thorac Cardiovasc Surg 1987; 20:191-4 
4. Sohail MR, Uslan DZ, Khan AH, et al. Management and outcome of permanent pacemaker and implantable cardioverter- defibrillator infections. J Am Coll Cardiol 2007;49:1851-9 
5. Bracke F, Meijer, A, van Gelder B. Extraction of pacemaker and implantable cardioverter defibrillator leads: patient and lead characteristics in relation to the requirement of extraction tools. Pacing Clin Electrophysiol 2002;25:1037-40 
6. Bracke F, Meijer A, van Gelder LM. Lead extraction for device related infections: a single-centre experience. Europace 2004;6:243-7 

이 논문을 인용한 문헌 (2)

1. Oh, Tak-Hyuck ; Kim, Gun-Jik ; Lee, Jong-Tae 2010. "Extraction of an Infected Permanent Pacemaker Lead Using Cardiopulmonary Bypass - 2 case reports -" 大韓胸部外科學會誌 = The Korean journal of thoracic and cardiovascular surgery, 43(1): 86~88  원문보기 상세보기
2. Choi, Kwang-Ho ; Yoon, Young-Chul ; Park, Kyung-Taek ; Lee, Yang-Haeng ; Hwang, Youn-Ho ; Cho, Kwang-Hyun 2010. "Removal of an Infected Permanent Pacemaker through a Right Atriotomy without Cardiopulmonary Bypass Via a Right Thoracotomy" 大韓胸部外科學會誌 = The Korean journal of thoracic and cardiovascular surgery, 43(4): 421~423  원문보기 상세보기